A novel use for routine CBCT imaging during radiotherapy to detect COVID-19.


Journal

Radiography (London, England : 1995)
ISSN: 1532-2831
Titre abrégé: Radiography (Lond)
Pays: Netherlands
ID NLM: 9604102

Informations de publication

Date de publication:
02 2022
Historique:
received: 02 03 2021
revised: 21 06 2021
accepted: 11 07 2021
pubmed: 2 8 2021
medline: 14 1 2022
entrez: 1 8 2021
Statut: ppublish

Résumé

Thoracic CT is a useful tool in the early diagnosis of patients with COVID-19. Typical appearances include patchy ground glass shadowing. Thoracic radiotherapy uses daily cone beam CT imaging (CBCT) to check for changes in patient positioning and anatomy prior to treatment through a qualitative assessment of lung appearance by radiographers. Observation of changes related to COVID-19 infection during this process may facilitate earlier testing improving patient management and staff protection. A tool was developed to create overview reports for all CBCTs for each patient throughout their treatment. Reports contain coronal maximum intensity projection (MIP's) of all CBCTs and plots of lung density over time. A single therapeutic radiographer undertook a blinded off-line audit that reviewed 150 patient datasets for tool optimisation in which medical notes were compared to image findings. This cohort included 75 patients treated during the pandemic and 75 patients treated between 2014 and 2017. The process was repeated retrospectively on a subset of the 285 thoracic radiotherapy patients treated between January-June 2020 to assess the efficiency of the tool and process. Three patients in the n = 150 optimisation cohort had confirmed COVID-19 infections during their radiotherapy. Two of these were detected by the reported image assessment process. The third case was not detected on CBCT due to minimal density changes in the visible part of the lungs. Within the retrospective cohort four patients had confirmed COVID-19 based on RT-PCR tests, three of which were retrospectively detected by the reported process. The preliminary results indicate that the presence of COVID-19 can be detected on CBCT by therapeutic radiographers. This process has now been extended to clinical service with daily assessments of all thoracic CBCTs. Changes noted are referred for oncologist review.

Identifiants

pubmed: 34332857
pii: S1078-8174(21)00091-2
doi: 10.1016/j.radi.2021.07.011
pmc: PMC8299223
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

17-23

Informations de copyright

Copyright © 2021 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest statement None.

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Auteurs

A Clough (A)

The Christie NHSFT, Manchester, United Kingdom. Electronic address: abigael.clough@nhs.net.

J Sanders (J)

The Christie NHSFT, Manchester, United Kingdom.

K Banfill (K)

The Christie NHSFT, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

C Faivre-Finn (C)

The Christie NHSFT, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

G Price (G)

The Christie NHSFT, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

C L Eccles (CL)

The Christie NHSFT, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

M C Aznar (MC)

Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

M Van Herk (M)

The Christie NHSFT, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

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Classifications MeSH